From the Huaxi MR Research Center (HMRRC), Department of Radiology (X.S., D.L., Q.G.), and Department of Neurology (N.L., L.C., R.P.), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, England (D.L.) Department of Medical Information Engineering, School of Electrical Engineering and Information, Sichuan University, Chengdu, Sichuan, China (F.C.); Department of Radiology, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, Zhengzhou, Henan, China (M.W.); and Department of Musculoskeletal Biology and MRC-Arthritis Research UK Centre for Integrated Research into Musculoskeletal Ageing (CIMA), Faculty of Health and Life Sciences, University of Liverpool, Liverpool, England (G.J.K.).
Radiology. 2017 Dec;285(3):904-913. doi: 10.1148/radiol.2017162929. Epub 2017 Sep 4.
Purpose To use resting-state functional magnetic resonance (MR) imaging and graph theory approaches to investigate the brain functional connectome and its potential relation to disease severity in Parkinson disease (PD). Materials and Methods This case-control study was approved by the local research ethics committee, and all participants provided informed consent. There were 153 right-handed patients with PD and 81 healthy control participants recruited who were matched for age, sex, and handedness to undergo a 3-T resting-state functional MR examination. The whole-brain functional connectome was constructed by thresholding the Pearson correlation matrices of 90 brain regions, and the topologic properties were analyzed by using graph theory approaches. Nonparametric permutation tests were used to compare topologic properties, and their relationship to disease severity was assessed. Results The functional connectome in PD showed abnormalities at the global level (ie, decrease in clustering coefficient, global efficiency, and local efficiency, and increase in characteristic path length) and at the nodal level (decreased nodal centralities in the sensorimotor cortex, default mode, and temporal-occipital regions; P < .001, false discovery rate corrected). Further, the nodal centralities in left postcentral gyrus and left superior temporal gyrus correlated negatively with Unified Parkinson's Disease Rating Scale III score (P = .038, false discovery rate corrected, r = -0.198; and P = .009, false discovery rate corrected, r = -0.270, respectively) and decreased with increasing Hoehn and Yahr stage in patients with PD. Conclusion The configurations of brain functional connectome in patients with PD were perturbed and correlated with disease severity, notably with those responsible for motor functions. These results provide topologic insights into understanding the neural functional changes in relation to disease severity of PD. RSNA, 2017 Online supplemental material is available for this article. An earlier incorrect version of this article appeared online. This article was corrected on September 11, 2017.
目的 使用静息态功能磁共振成像和图论方法研究帕金森病（PD）患者的脑功能连接组及其与疾病严重程度的潜在关系。
材料与方法 本病例对照研究经当地研究伦理委员会批准，所有参与者均签署知情同意书。共纳入 153 例右侧 PD 患者和 81 例健康对照者，两组在年龄、性别和利手方面相匹配，均行 3-T 静息态功能磁共振检查。通过对 90 个脑区的 Pearson 相关矩阵进行阈值处理构建全脑功能连接组，采用图论方法分析拓扑属性。采用非参数置换检验比较拓扑属性，并评估其与疾病严重程度的关系。
结果 PD 患者的功能连接组在全局水平（即聚类系数、全局效率和局部效率降低，特征路径长度增加）和节点水平（感觉运动皮质、默认模式和颞枕区的节点中心度降低，P<.001，经假发现率校正）存在异常。此外，左侧中央后回和左侧颞上回的节点中心度与帕金森病评定量表第 3 部分评分呈负相关（P=.038，经假发现率校正，r=-0.198；P=.009，经假发现率校正，r=-0.270），且与 PD 患者 Hoehn 和 Yahr 分期呈负相关。
结论 PD 患者的脑功能连接组结构发生紊乱，并与疾病严重程度相关，特别是与运动功能相关的脑区。这些结果为理解 PD 患者与疾病严重程度相关的神经功能变化提供了拓扑学见解。
RSNA，2017 在线补充材料可从本文获取。本文早期曾在线发布错误版本，已对该文进行校正，校正日期为 2017 年 9 月 11 日。
